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Ginkgo biloba and global cognition: grade N

No benefit shown evidence. Direction: No effect.

N No benefit shown

Educational guidance, not medical advice

Why this grade

Rubric condition met: Adequate human RCTs found no meaningful effect: one large well-run RCT (GEM, n = 3,069, median 6.1 years, publicly funded with manufacturer-donated tablets, registered NCT00010803) plus a moderate-certainty Cochrane finding of little or no effect in MCI

The GEM trial randomized 3,069 adults aged 72-96 to 120 mg twice daily or placebo and found no difference in annual rates of change in any cognitive domain over a median 6.1 years, with no effect modification by age, sex or baseline status. The 2026 Cochrane review found moderate-certainty evidence of little or no effect at six months in people with MCI (a clinical population). Low-certainty benefits reported in people with dementia are clinical-population findings and are not used for this grade.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)2000200520102015202020252030Meta-analysisRCTWieland 2026, 2026: meta-analysis, n = 10,613, result not recordedSnitz 2009, 2009: RCT, n = 3,069, result not recordedSolomon 2002, 2002: RCT, n = 230, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Solomon 20022002RCT230result not recorded
Snitz 20092009RCT3069result not recorded
Wieland 20262026meta-analysis10613result not recorded

Ginkgo biloba for cognitive impairment and dementia.

Wieland LS, Ludeman E, Chi Y. Ginkgo biloba for cognitive impairment and dementia Cochrane Database Syst Rev, 2026. PMID 41641880

Result not recorded
Design
Cochrane systematic review and meta-analysis of 82 RCTs
Sample
n = 10,613
Population
People with cognitive complaints, mild cognitive impairment or dementia (clinical populations)
Funding
not stated in PubMed record

Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial.

Snitz BE, O'Meara ES, Carlson MC. Ginkgo biloba for preventing cognitive decline in older adults: a randomized trial JAMA, 2009. PMID 20040554

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial (GEM study), median follow-up 6.1 years
Sample
n = 3,069
Population
Community-dwelling adults aged 72-96 with normal cognition or mild cognitive impairment
Funding
NIA and NCCIH (NIH) grants (PubMed grant list)

Ginkgo for memory enhancement: a randomized controlled trial.

Solomon PR, Adams F, Silver A. Ginkgo for memory enhancement: a randomized controlled trial JAMA, 2002. PMID 12186600

Result not recorded
Design
Six-week randomized, double-blind, placebo-controlled, parallel-group trial
Sample
n = 230
Population
Healthy adults older than 60 without cognitive impairment
Funding
NIA NIH HHS AGO-5134-08S2 (PubMed grant list)

Search and history

Search (): ginkgo[ti] AND (cognitive decline[tiab] OR cognitive function[tiab]) AND (older[tiab] OR elderly[tiab]) AND randomized controlled trial[pt] AND humans[mh]

  • Graded N (proposed): Proposed in the monograph draft
  • N to N (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page